Chavez Ligia M, Shrout Patrick E, Wang Ye, Collazos Francisco, Carmona Rodrigo, Alegría Margarita
Behavioral Sciences Research Institute, University of Puerto Rico Medical Sciences Campus, Río Piedras, PR 00935, USA.
Department of Psychology,New York University 6 Washington Place, Room 455 New York, NY 10003, USA.
Drug Alcohol Depend. 2017 Nov 1;180:121-128. doi: 10.1016/j.drugalcdep.2017.07.042. Epub 2017 Aug 24.
Early detection and intervention in primary care is integral to behavioral health. Valid, practical screening assessments are scarce, particularly for non-English speaking populations. We address this need by evaluating the psychometric properties of the Spanish version of the AC-OK Screen for Co-occurring Disorders for first and second generation immigrant Latinos in Massachusetts, USA, and Madrid and Barcelona, Spain.
567 Latino participants were recruited in waiting areas of clinics or by referral from Primary Care, Mental Health, Substance Use, and HIV Treatment Clinics, as well as Community Agencies. We use confirmatory factor analyses to evaluate the factor structure, correlation analysis to examine concurrent and discriminant validity, and receiver operating curves (ROC) to determine the ability of the AC-OK to approximate a composite of established instruments designed to measure depression, generalized anxiety, post-traumatic stress disorder symptoms, alcohol, and drugs (including benzodiazepines) as external criteria.
The original two factor structure was replicated in samples of Latino respondents in the US and Spain. Correlations with other measures followed the expected pattern. In both the US and Spain, ROC analyses suggested that the AC-OK scale was an adequate approximation to other specific measures of mental health (ROC=0.90) and substance abuse problems (ROC=0.83).
The Spanish version of the AC-OK Screen has good to excellent psychometric properties in both its subscales. These findings are robust across sites, gender, and type of clinic. We recommend its use for clinical research and for routine screening at treatment centers.
基层医疗中的早期检测和干预对于行为健康至关重要。有效的、实用的筛查评估工具稀缺，尤其是针对非英语人群。我们通过评估美国马萨诸塞州以及西班牙马德里和巴塞罗那的第一代和第二代移民拉丁裔的西班牙语版AC-OK共病筛查工具的心理测量特性来满足这一需求。
567名拉丁裔参与者是在诊所候诊区招募的，或者是由初级保健、心理健康、物质使用和艾滋病毒治疗诊所以及社区机构转介而来。我们使用验证性因素分析来评估因素结构，使用相关性分析来检验同时效度和区分效度，并使用受试者工作特征曲线（ROC）来确定AC-OK工具接近旨在测量抑郁、广泛性焦虑、创伤后应激障碍症状、酒精和药物（包括苯二氮卓类）的既定工具组合作为外部标准的能力。
在美国和西班牙的拉丁裔受访者样本中复制了最初的两因素结构。与其他测量方法的相关性遵循预期模式。在美国和西班牙，ROC分析均表明AC-OK量表与其他心理健康特定测量方法（ROC = 0.90）和药物滥用问题（ROC = 0.83）充分近似。
西班牙语版AC-OK筛查工具在其两个子量表中均具有良好到优秀的心理测量特性。这些发现不受地点、性别和诊所类型的影响。我们建议将其用于临床研究以及治疗中心的常规筛查。
